背景:已经报道了使用磁共振成像(MRI)细胞外体积分数(ECV)监测tafamidis治疗效果的有用性。
目的:我们进行了荟萃分析以评估该方法的有用性。
方法:提取来自6项研究的246例ATTR-CM的数据并纳入分析。使用随机效应模型进行逆方差荟萃分析,以评估tafamidis治疗前后MRI-ECV的变化。还通过将患者分类为ATTR-CM类型(野生型或遗传性)来进行分析。
结果:tafamidis治疗前后的ECV变化为0.33%(95%CI:-1.83-2.49,I2=0%,异质性p=0.76)在治疗组中为4.23%(95%CI:0.44-8.02,I2=0%,非治疗组的异质性p=0.18)。治疗组治疗前后ECV变化不显著(p=0.76),但在非治疗组中有显著增加(p=0.03)。野生型(95%CI:-2.65-3.40)和遗传性(95%CI:-9.28-4.28)之间的ECV变化没有差异(p=0.45)。
结论:这项荟萃分析的结果表明,MRI-ECV测量是一种有用的成像方法,可以无创评估tafamidis治疗ATTR-CM的疗效。
BACKGROUND: The usefulness of monitoring treatment effect of tafamidis using magnetic resonance imaging (MRI) extracellular volume fraction (ECV) has been reported.
OBJECTIVE: we conducted a meta-analysis to evaluate the usefulness of this method.
METHODS: Data from 246 ATTR-CMs from six studies were extracted and included in the analysis. An inverse variance meta-analysis using a random effects model was performed to evaluate the change in MRI-ECV before and after tafamidis treatment. The analysis was also performed by classifying the patients into ATTR-CM types (wild-type or hereditary).
RESULTS: ECV change before and after tafamidis treatment was 0.33% (95% CI: -1.83-2.49, I2 = 0%, p = 0.76 for heterogeneity) in the treatment group and 4.23% (95% CI: 0.44-8.02, I2 = 0%, p = 0.18 for heterogeneity) in the non-treatment group. The change in ECV before and after treatment was not significant in the treated group (p = 0.76), but there was a significant increase in the non-treated group (p = 0.03). There was no difference in the change in ECV between wild-type (95% CI: -2.65-3.40) and hereditary-type (95% CI: -9.28-4.28) (p = 0.45).
CONCLUSIONS: The results of this meta-analysis suggest that MRI-ECV measurement is a useful imaging method for noninvasively evaluating the efficacy of tafamidis treatment for ATTR-CM.